What is a hysterosalpingogram?
HSG (hysterosalpingography) is an x-ray test used to view your reproductive organs. It is primarily used to evaluate the openness of the fallopian tubes. HSG is done in an x-ray room in the radiology department. During the procedure, a radiologist (a doctor who specialized in the use of x-rays) takes images as a contrast dye flows through the uterus and fallopian tubes. The dye makes it easier to see these organs on x-rays. It can also help pinpoint the location of problems. These problems can include a blockage or narrowing of the fallopian tubes, abnormalities in the shape and size of the fallopian tubes and uterus, and growths in the uterus.
Before The HSG
- The procedure will be scheduled only on days 6-12 after the first day of your last menstrual period.
- A day or two before the exam, avoid sexual intercourse, stop using creams or other vaginal medications, and avoid douching.
- You may take over-the-counter pain medications a few hours before the test.
- No food or liquids for 2 hours prior to the procedure. However, you may take all regular medications as scheduled with small sips of water.
- Report any allergies to the radiology nurse, especially those to iodine contrast (x-ray dye).
- Women should always inform the x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation.
During The Hysterosalpingogram
- You will be positioned lying on your back on the x-ray table with your knees bent, much like a Pap test.
- An instrument called a speculum is inserted into the vagina to hold it open.
- The cervix is cleansed with an antiseptic solution.
- Then a catheter (a long, thin, hollow plastic tube) is guided through the cervix and into the uterus.
- The radiologist will position the x-ray machine over your abdomen. Then contrast dye is injected through the catheter.
- The dye may stretch the uterus and tubes, causing some cramping or pain.
- As the dye flows through the uterus and tubes, x-rays are taken. You will be asked to change positions.
- It is normal for some of the dye to spill out of the tubes and be absorbed by the body. The rest may appear later as vaginal discharge.
Potential Risks and Complications
- Bleeding at the procedure site
- Infection at the procedure site
- Problems due to iodine contrast, including allergic reaction or kidney damage
- Damage to the uterus or fallopian tubes (very rare)
After The HSG Exam
- You will likely have a thick discharge with some bleeding as some of the dye drains out of the uterus. Use pads, not tampons, until the discharge is gone.
- For a few hours you may feel cramping. This can usually be relieved with over-the-counter pain medications.
Call your doctor if you have any of the following:
- A fever over 101°F
- Heavy vaginal bleeding (more than a pad an hour for 2 hours)
- Severe or increasing pelvic pain
- Foul-smelling or unusual vaginal discharge
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Your results will be sent to your doctor by the following day.